CERTIFICATE OF ATTENDANCE REQUEST FORM
CONTINUING NURSING PROFESSIONAL EDUCATION (CNPE)
Ingram School of Nursing, Faculty of Medicine, McGill University
Please complete this Certificate of Attendance Request form. To be submitted two (2) weeks before the start
date of the activity.
The information below will be displayed on the certificate of attendance provided to you by
the CNPE Office.
Educational Activity Title: (Exact wording as it appears on certificate).
Date of event:
Name of Organizing Committee Chair:
The cost of certificates is $5.00/each. McGill/MUHC activities: Reduced rate will apply. A
shipping/handling fee will be charged if delivery is outside of the MUHC.
Quantity of Certificates:
English:
French:
Shipping Address: (Organization name, civil address, room number, city, postal code, etc...)
Name of the person who submitted form:
Email:
Telephone number:
Maximum Number Credits (Completed by CNPE Office):
CNPE OFFICE Ingram School of Nursing
McGill University
3506 University Room 215
Montreal, Quebec, H3A2A7
CNPE Office Use
Date form received:
cnpeoffice.nursing@mcgill.ca
Dec. 2014